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Giornale Italiano Di Dermatologia E... Dec 2020
Topics: Adult; Aged; Aged, 80 and over; Carcinoma in Situ; Combined Modality Therapy; Female; Follow-Up Studies; Gynecologic Surgical Procedures; Humans; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Paget Disease, Extramammary; Perineum; Plastic Surgery Procedures; Vulvar Neoplasms
PubMed: 30430813
DOI: 10.23736/S0392-0488.18.06186-2 -
Ceska Gynekologie 2022A comprehensive overview of the surgical treatment of vulvar cancer, including recurrent forms. (Review)
Review
OBJECTIVE
A comprehensive overview of the surgical treatment of vulvar cancer, including recurrent forms.
METHODOLOGY
A review work providing a basic overview of the pathogenesis, dia-gnosis and surgical treatment of vulvar cancer with a focus on the possibilities of treatment of its recurrences. It includes an illustrative case report presenting a patient with invasive squamous cell carcinoma of the vulva with iterative local recurrences and subsequent development of tumor triplicity and distant metastatic involvement.
CONCLUSION
Surgical treatment remains the main modality of vulvar cancer therapy, even in the case of locally advanced or recurrent findings. In these cases, multidisciplinary cooperation of operational fields is necessary. The discipline of treated patients with participation in regular dispensary care plays an important role in the early detection of recurrences. (Chemo) radiotherapy remains a possible alternative to the surgical solution; in clinical practice, radiotherapy has an irreplaceable place in adjuvant therapy. Regional and distant recurrences are characterized by a poor prognosis.
Topics: Female; Humans; Vulvar Neoplasms; Neoplasm Recurrence, Local; Vulva; Carcinoma, Squamous Cell; Recurrence; Neoplasm Staging; Retrospective Studies
PubMed: 36543587
DOI: 10.48095/cccg2022401 -
International Journal of... Jun 2015Malignant tumors of the female reproductive system are a serious health and social problem, as they are the second most common cause of death among women, after breast... (Review)
Review
Malignant tumors of the female reproductive system are a serious health and social problem, as they are the second most common cause of death among women, after breast cancer. Their incidence has increased dramatically during recent years, probably due to the different sexual habits and changes in the prevalence of HIV/ AIDS and HPV virus carriers, among other factors. Vulvar tumors represent only 4% of all gynecological neoplasms, and they are fourth in frequency after tumors of the cervix, uterus, and ovary. Ninety eight percent of all vulvar tumors are benign and only 2% are malignant. The overall incidence of tumors with vulvar location is between two and seven cases per 100,000 women, and it increases with age, while the death rate is estimated at 0.7 per 100,000 women. Sarcomas of the vulva comprise approximately 1-3% of all vulvar cancers, with leiomyosarcomas, epithelioid sarcomas, and rhabdomyosarcomas being the most common among them. They are characterized by rapid growth, high metastatic potential, frequent recurrences, aggressive behavior, and high mortality rate. In this paper, we present the most common forms of sarcomas of the vulva (leiomyosarcoma, epithelioid sarcoma, malignant rhabdoid tumor, rhabdomyosarcoma) in order to emphasize the broad differential diagnosis, rare appearance, non-specific clinical picture, aggressive course, and high mortality.
Topics: Diagnosis, Differential; Female; Humans; Neoplasm Recurrence, Local; Sarcoma; Vulvar Neoplasms
PubMed: 25816394
DOI: 10.1177/0394632015576029 -
International Journal of Gynecological... May 2017Extramammary Paget's disease is a rare condition, and the vulva is a common site for it to occur. Despite this, there is a paucity of literature on Paget's disease of...
BACKGROUND
Extramammary Paget's disease is a rare condition, and the vulva is a common site for it to occur. Despite this, there is a paucity of literature on Paget's disease of the vulva (VPD). A Cochrane meta-analysis could not draw any conclusions on interventions in VPD. Our aim was to review our practice and improve further management of VPD in our center.
METHODS
We reviewed all the cases presented to Leeds Gynaecological Oncology Centre between 1988 and 2016. All cases identified in this interval were followed up until April 2016. All case notes and electronic patient data were retrieved to collate the data.
RESULTS
We identified 18 cases of VPD. The median age at presentation was 76.9 years. Primary surgery was used in 18 cases. Eight patients had wide local excision with graft reconstruction. Ten women had wide local excision with primary reconstruction. Margins were negative in 27% of the excisions. Sixty percent of patients with clear surgical margins had a recurrence, and 69% of patients with positive margins had a recurrence; there was no statistical difference between the 2 groups for recurrence (P > 0.05). Fifty-eight percent of patients who had recurrence had coexisting malignancy. Logistic regression showed no correlation of recurrence rates due to either age, margin status, or coexisting malignancies.
CONCLUSIONS
Paget's disease of the vulva is a rare condition. Our experience indicates that most cases may be amenable to surgical treatment at first presentation. Negative margin status does not reduce the chance of recurrence, and hence patients should be under follow-up for life. The benefit of radical surgery in the absence of reduced recurrences, based on margin status, is questionable. Radiotherapy and imiquimod are options for extensive lesions or recurrent settings. Coexisting malignancies are associated with VPD.
Topics: Adult; Aged; Aged, 80 and over; Aminoquinolines; Antineoplastic Agents; Female; Humans; Imiquimod; Logistic Models; Middle Aged; Neoplasm Recurrence, Local; Paget Disease, Extramammary; Vulvar Neoplasms
PubMed: 28441252
DOI: 10.1097/IGC.0000000000000901 -
The Journal of Reproductive Medicine Nov 1990Granular cell tumor (GCT), although nearly ubiquitous, is seen infrequently in the vulva. A review of the surgical pathology files from Grady Memorial Hospital, Atlanta,... (Review)
Review
Granular cell tumor (GCT), although nearly ubiquitous, is seen infrequently in the vulva. A review of the surgical pathology files from Grady Memorial Hospital, Atlanta, Georgia, from 1983 through 1987 identified eight cases of vulvar GCT. Five of the eight patients had more than one skin and soft tissue lesion. Two of the five had biopsy-proven multicentric GCT with a unique clinical course. One of the patients was a 32-year-old woman with multiple vulvar, lingual, laryngeal, bronchial and pulmonary GCT, necessitating multiple excisions and ultimately pneumonectomy. The second patient had multiple GCTs in the vulva and inguinal area and finally in both lungs, resulting in her death at age 39. No dependable microscopic features could be identified to distinguish benign GCT from its more aggressive variant. However, Feulgen DNA histomorphometry demonstrated aneuploidy in the patient with apparent lung metastases, whereas the tumors from patients with a benign course as well as from the patient with multiorgan involvement were diploid. In three of five patients who could be interviewed there was a history of soft tissue tumors in members of the family. The multifocal nature and possible familial component of GCT need to be explored further.
Topics: Adult; Aged; DNA, Neoplasm; Female; Humans; Middle Aged; Neoplasms, Muscle Tissue; Ploidies; Vulvar Neoplasms
PubMed: 2277361
DOI: No ID Found -
Current Opinion in Obstetrics &... Jun 1990
Review
Topics: Biopsy; Carcinoma, Squamous Cell; Female; Humans; Melanoma; Neoplasm Staging; Papillomaviridae; Terminology as Topic; Tumor Virus Infections; Vulvar Diseases; Vulvar Neoplasms
PubMed: 1966322
DOI: No ID Found -
Revista Brasileira de Ginecologia E... Oct 2016Extramammary Paget disease (EPD) is a rare malign neoplasm that may affect the vulva and has manifestations common to benign diseases such as itching, pain and eczema....
Extramammary Paget disease (EPD) is a rare malign neoplasm that may affect the vulva and has manifestations common to benign diseases such as itching, pain and eczema. This leads to delay in diagnosis and consequent worse prognosis. The definitive diagnosis is obtained by biopsy of the vulva, which shows Paget cells. The treatment of choice is wide excision with margins, which leads to sequelae, functional and aesthetic. Recurrence is common. This article reports the case of a 48-year-old female patient with history of vulvar itching for the past 2 years, who had been submitted to various treatments for benign pathologies. The patient was biopsied and was diagnosed with extensive EPD, being submitted to vulvectomy. This article aims to draw attention to the need for biopsy of pruritic vulvar lesions that do not respond to usual treatment.
Topics: Female; Humans; Middle Aged; Paget Disease, Extramammary; Vulvar Neoplasms
PubMed: 27832673
DOI: 10.1055/s-0036-1593884 -
Journal of Cancer Research and... 2015Aggressive angiomyxoma is a rare mesenchymal neoplasm that typically affects females of reproductive age. It involves preferentially pelvic and perineal regions and was...
Aggressive angiomyxoma is a rare mesenchymal neoplasm that typically affects females of reproductive age. It involves preferentially pelvic and perineal regions and was first described by Steeper and Rosai in 1983. Peak age of incidence for this tumor is in the fourth decade with very few cases reported in young girls. We present a case of this rare tumor in a 13-year-old female.
Topics: Adolescent; Female; Humans; Myxoma; Treatment Outcome; Vulvar Neoplasms
PubMed: 26881549
DOI: 10.4103/0973-1482.159081 -
The Journal of Obstetrics and... Jul 2022Myoepithelioma-like tumors of the vulvar region (MELTVR) is a kind of solid tumor newly recognized in recent years, which is characterized by mesenchymal tumors of adult... (Review)
Review
Myoepithelioma-like tumors of the vulvar region (MELTVR) is a kind of solid tumor newly recognized in recent years, which is characterized by mesenchymal tumors of adult female vulva. The histopathology is similar to myoepithelioma, but the immunohistochemical phenotype and genetic changes are different from myoepithelioma. It usually has clear boundary and partial capsule, mixed with two forms of cells (epithelioid and spindle), the cells are mild, the nucleoli are clear, mitoses are rare, some cases have myxoid differentiation. In this article, a case of MELTVR diagnosed in our hospital is discussed. The patient was a 43-year-old female who finds a neoplasm in the pubic tubercle 4 months ago. Local resection was performed. Pathological examination showed that the boundary of the tumor was clear with partial capsule. The cells were arranged in cords or nests, and partially infiltrated the surrounding adipocytes. The tumor cells had two morphologies, epithelioid or spindle shaped. The spindle type cells were dominant, with bright cytoplasm, obvious nucleoli, rare nuclear mitosis (about 1/10HPF), and no necrosis was observed. Immunohistochemically, the tumor cells were positive for vimentin, epithelial membrane antigen, estrogen receptor, progestogen receptor, calponin and were partially positive for cathepsin k. INI1/SMARCB1 expression was deficient. There was no recurrence or metastasis during the 8-month-long follow-up. The unique feature of this case was that the site of the disease was not the vulva, but in front of the pubic tubercle, there was no large amount of mucus production, and the cytoplasm of most tumor cells was transparent. Due to our limited knowledge of MELTVR, its pathogenesis and tissue origin are not clear. Clinicians should be aware of such potential patients.
Topics: Biomarkers, Tumor; Female; Humans; Immunohistochemistry; Myoepithelioma; Receptors, Estrogen; Vulvar Neoplasms
PubMed: 35581677
DOI: 10.1111/jog.15286 -
Women's Health (London, England) Sep 2009Treatment for early-stage vulvar carcinoma has evolved from radical en bloc dissection to wide local incision with lymphadenectomy through separate groin incisions, to... (Review)
Review
Treatment for early-stage vulvar carcinoma has evolved from radical en bloc dissection to wide local incision with lymphadenectomy through separate groin incisions, to sentinel lymph node biopsy (SLNB). The morbidity of SLNB is far less than traditional inguinofemoral lymphadenectomy, with less lymphedema and sensory deficit, shorter hospital stays and fewer infections. A multidisciplinary approach is required, with success of the SLNB technique maximized when radiolabeled colloid is used, with blue dye added when further identification is needed. Frozen-section analysis, followed by ultrastaging of the nodal sample, minimizes the need for reoperations and decreases the risk of false negatives. We believe that SLNB will become the standard of care for treatment of early-stage vulvar carcinoma.
Topics: Female; Gynecologic Surgical Procedures; Humans; Lymphatic Diseases; Neoplasm Staging; Sentinel Lymph Node Biopsy; Vulva; Vulvar Neoplasms
PubMed: 19702454
DOI: 10.2217/whe.09.37